Provider Demographics
NPI:1619062239
Name:ESCOTT, KAREN (DC)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:
Last Name:ESCOTT
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 CONNORS CT
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHICO
Mailing Address - State:CA
Mailing Address - Zip Code:95926
Mailing Address - Country:US
Mailing Address - Phone:530-345-4204
Mailing Address - Fax:530-345-6874
Practice Address - Street 1:389 CONNORS CT
Practice Address - Street 2:SUITE C
Practice Address - City:CHICO
Practice Address - State:CA
Practice Address - Zip Code:95926
Practice Address - Country:US
Practice Address - Phone:530-345-4204
Practice Address - Fax:530-345-6874
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21315111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA94-3363163OtherTAX PAYER ID
CAU31629Medicare UPIN
CADC0213150Medicare ID - Type Unspecified